Department of Cardiac Sciences, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Angiology. 2012 Feb;63(2):119-26. doi: 10.1177/0003319711409565. Epub 2011 May 20.
The prognostic value of admission estimated glomerular filtration rate (eGFR) calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula for cardiovascular adverse outcomes in acute coronary syndrome (ACS) was explored. Baseline eGFR was classified as no renal dysfunction (>90 mL/min per 1.73 m(2)), borderline (90-60.1 mL/min per 1.73 m(2)), moderate (60-30.1 mL/min per 1.73 m(2)), or severe (≤30 mL/min per 1.73 m(2)) renal dysfunction. Of the 5034 patients, 3415 (67.8%) had eGFR <90. Compared to patients with an eGFR ≥60 mL/min per 1.73 m(2), patients with <60 mL/min per 1.73 m(2) were less likely to be treated with β-blockers, angiotensin-converting enzyme inhibitors, or statins, or to undergo percutaneous coronary interventions. Lower eGFR showed a stepwise association with significantly worse adverse in-hospital outcomes. The adjusted odds ratio of in-hospital death with an eGFR <30 mL/min per 1.73 m(2) was 3.1 (95% confidence interval 1.1-8.4, P = .0324), compared with an eGFR >90 mL/min per 1.73 m(2). Estimated glomerular filtration rate calculated by the new CKD-EPI is an independent predictor of major adverse cardiac outcomes in patients with ACS.
探讨了应用慢性肾脏病流行病学合作（CKD-EPI）公式估算的入院时肾小球滤过率（eGFR）对急性冠状动脉综合征（ACS）患者心血管不良结局的预后价值。将基线 eGFR 分为肾功能正常（>90 mL/min/1.73 m²）、边缘状态（90-60.1 mL/min/1.73 m²）、中度（60-30.1 mL/min/1.73 m²）或严重（≤30 mL/min/1.73 m²）肾功能不全。在 5034 例患者中，3415 例（67.8%）的 eGFR<90。与 eGFR≥60 mL/min/1.73 m²的患者相比，eGFR<60 mL/min/1.73 m²的患者更不可能接受β受体阻滞剂、血管紧张素转换酶抑制剂或他汀类药物治疗，或接受经皮冠状动脉介入治疗。较低的 eGFR 与不良院内结局显著恶化呈逐步相关。eGFR<30 mL/min/1.73 m²的患者院内死亡的调整比值比为 3.1（95%置信区间 1.1-8.4，P=0.0324），而 eGFR>90 mL/min/1.73 m²的患者为 1.0。应用新 CKD-EPI 估算的肾小球滤过率是 ACS 患者主要不良心脏结局的独立预测因子。
